Abstract
Periviable infants (i.e., those born in the 20th through 26th weeks of gestation) suffer much morbidity and approximately half die in the first year of life. Attempts to explain and predict these births disproportionately invoke a “dysregulation” narrative. Research inspired by this narrative has not led to efficacious interventions. The clinical community has, therefore, urged novel approaches to the problem. We aim to provoke debate by offering the theory, inferred from microeconomics, that risk tolerant women carry, without cognitive involvement, high risk fetuses farther into pregnancy than do other women. These extended high-risk pregnancies historically ended in stillbirth but modern obstetric practices now convert a fraction to periviable births. We argue that this theory deserves testing because it suggests inexpensive and noninvasive screening for pregnancies that might benefit from the costly and invasive interventions clinical research will likely devise.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 281-284 |
| Number of pages | 4 |
| Journal | Social Science and Medicine |
| Volume | 233 |
| DOIs |
|
| State | Published - Jul 1 2019 |
| Externally published | Yes |
Fingerprint
Keywords
- Periviable birth
- Reproductive suppression
- Risk tolerance
- Spontaneous abortion
ASJC Scopus subject areas
- Health(social science)
- History and Philosophy of Science
Cite this
Understanding periviable birth : A microeconomic alternative to the dysregulation narrative. / Catalano, Ralph; Bruckner, Tim; Avalos, Lyndsay A.; Stewart, Holly; Karasek, Deborah; Kariv, Shachar; Gemmill, Alison; Saxton, Katherine; Casey, Joan.
In: Social Science and Medicine, Vol. 233, 01.07.2019, p. 281-284.Research output: Contribution to journal › Comment/debate
}
TY - JOUR
T1 - Understanding periviable birth
T2 - A microeconomic alternative to the dysregulation narrative
AU - Catalano, Ralph
AU - Bruckner, Tim
AU - Avalos, Lyndsay A.
AU - Stewart, Holly
AU - Karasek, Deborah
AU - Kariv, Shachar
AU - Gemmill, Alison
AU - Saxton, Katherine
AU - Casey, Joan
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Periviable infants (i.e., those born in the 20th through 26th weeks of gestation) suffer much morbidity and approximately half die in the first year of life. Attempts to explain and predict these births disproportionately invoke a “dysregulation” narrative. Research inspired by this narrative has not led to efficacious interventions. The clinical community has, therefore, urged novel approaches to the problem. We aim to provoke debate by offering the theory, inferred from microeconomics, that risk tolerant women carry, without cognitive involvement, high risk fetuses farther into pregnancy than do other women. These extended high-risk pregnancies historically ended in stillbirth but modern obstetric practices now convert a fraction to periviable births. We argue that this theory deserves testing because it suggests inexpensive and noninvasive screening for pregnancies that might benefit from the costly and invasive interventions clinical research will likely devise.
AB - Periviable infants (i.e., those born in the 20th through 26th weeks of gestation) suffer much morbidity and approximately half die in the first year of life. Attempts to explain and predict these births disproportionately invoke a “dysregulation” narrative. Research inspired by this narrative has not led to efficacious interventions. The clinical community has, therefore, urged novel approaches to the problem. We aim to provoke debate by offering the theory, inferred from microeconomics, that risk tolerant women carry, without cognitive involvement, high risk fetuses farther into pregnancy than do other women. These extended high-risk pregnancies historically ended in stillbirth but modern obstetric practices now convert a fraction to periviable births. We argue that this theory deserves testing because it suggests inexpensive and noninvasive screening for pregnancies that might benefit from the costly and invasive interventions clinical research will likely devise.
KW - Periviable birth
KW - Reproductive suppression
KW - Risk tolerance
KW - Spontaneous abortion
UR - http://www.scopus.com/inward/record.url?scp=85059047968&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059047968&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2017.12.014
DO - 10.1016/j.socscimed.2017.12.014
M3 - Comment/debate
C2 - 29274689
AN - SCOPUS:85059047968
VL - 233
SP - 281
EP - 284
JO - Social Science and Medicine
JF - Social Science and Medicine
SN - 0277-9536
ER -